Flu vaccination in Alberta long-term care facilities

I wish to take issue with Margaret Russell's results and her interpretation of her findings concerning staff vaccination rates for influenza in long-term care facilities in Alberta.1 This is not a fair or accurate representation of the situation within the Calgary region over the past 2 seasons. I am perplexed as to why such a study should be reported at this time in CMAJ.

The average staff vaccination rate within all Calgary long-term care facilities has improved from 44% during the 1998–1999 season (the period studied by Russell) to 75% during the 2000–2001 season. Our long-term care facilities comprise a heterogeneous mix of 27 public, private and voluntary institutions.

The average staff vaccination rate at 25 long-term care facilities was 63% in 1999–2000. The average influenza vaccination rate for residents of long-term care facilities was 93% in 2000–2001 and 94% in 1999–2000. Much of this improvement was due to the introduction and adoption of a comprehensive standardized approach to the management of influenza and institutional outbreaks in the Calgary region since 1998. Recognition by attending physicians and nurses of influenza outbreaks in the community and seasonal mortality trends in long-term care facilities was facilitated directly by regionalization of health care services.

To state that “staff vaccination rates in Alberta long-term care facilities are unacceptably low” without qualifying the period of study is unhelpful. It may not be possible to improve significantly on our average resident vaccination rates but we expect continued improvement in staff vaccination rates. We are also targeting health care workers who are in contact with senior citizens living outside of long-term care facilities, such as in lodges and supported living environments. As a postscript, our surveillance for influenza failed to detect a single outbreak of influenza A within any long-term care facility in this region during the past season.